| Elm Street Family Dental | |
|
1036 Elm St Sw Albany OR 97321-2039 | |
| (541) 928-2993 | |
| (541) 926-0339 |
| Full Name | Elm Street Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1036 Elm St Sw, Albany, Oregon |
| Authorized Official Name and Position | Lane S Harris (MEMBER) |
| Authorized Official Contact | 5419282993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elm Street Family Dental 1036 Elm St Sw Albany OR 97321-2039 Ph: (541) 928-2993 | Elm Street Family Dental 1036 Elm St Sw Albany OR 97321-2039 Ph: (541) 928-2993 |
| NPI Number | 1003295015 |
|---|---|
| Provider Enumeration Date | 05/22/2015 |
| Last Update Date | 05/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003295015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D7193 (Oregon) | Primary |
| 1223G0001X | Dentist - General Practice | D9733 (Oregon) | Secondary |
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